Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
Delivering Quality: Maternity Care Innovation in Critical Access Hospitals
Presents case studies of six Critical Access Hospitals (CAHs) that are high performers on maternity care quality measures. Summarizes interviews with leaders from each CAH regarding the benefits of their Perinatal Quality Collaboratives, use of safety bundles, training activities, and other successes in providing maternity care.
Author(s): Madeleine Pick, Hamdi Abas, Megan Lahr, Mikayla Reinke
Date: 02/2026
Sponsoring organization: Flex Monitoring Team
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Presents case studies of six Critical Access Hospitals (CAHs) that are high performers on maternity care quality measures. Summarizes interviews with leaders from each CAH regarding the benefits of their Perinatal Quality Collaboratives, use of safety bundles, training activities, and other successes in providing maternity care.
Author(s): Madeleine Pick, Hamdi Abas, Megan Lahr, Mikayla Reinke
Date: 02/2026
Sponsoring organization: Flex Monitoring Team
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Improving the Value Proposition of Critical Access Hospitals – Lessons from Federal and State Initiatives
Report details how federal and state initiatives can support Critical Access Hospitals (CAHs) transition to value-based payment models. Provides examples of initiatives that offer models for use by State Flex Programs (SFPs) for supporting CAHs' transformation to value-based care.
Author(s): John Gale, Rebecca Stearns, Bridget Harr
Date: 02/2026
Sponsoring organization: Flex Monitoring Team
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Report details how federal and state initiatives can support Critical Access Hospitals (CAHs) transition to value-based payment models. Provides examples of initiatives that offer models for use by State Flex Programs (SFPs) for supporting CAHs' transformation to value-based care.
Author(s): John Gale, Rebecca Stearns, Bridget Harr
Date: 02/2026
Sponsoring organization: Flex Monitoring Team
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Prepublication Requirements: Requirement Revisions Related to NFPA Codes and CMS CoPs
Outlines new and revised Joint Commission requirements for Critical Access Hospitals (CAHs) effective March 1, 2026. Changes clarify elements of performance (EPs) based on National Fire Protection Association (NFPA) requirements and further align Joint Commission standards with Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs).
Date: 01/2026
Sponsoring organization: Joint Commission
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Outlines new and revised Joint Commission requirements for Critical Access Hospitals (CAHs) effective March 1, 2026. Changes clarify elements of performance (EPs) based on National Fire Protection Association (NFPA) requirements and further align Joint Commission standards with Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs).
Date: 01/2026
Sponsoring organization: Joint Commission
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Measuring State Flex Program Impact: Tools to Support Outcome Measurement and Evaluation
Toolkit designed to help State Flex Programs (SFPs) with manage and document project performance and comply with the Federal Office of Rural Health Policy's expectations regarding outcome measurement and reporting. Provides blank worksheets for SFPs as they work through the steps for their projects, as well as links to outcome measurement resources.
Author(s): John Gale, Bridget Harr
Date: 12/2025
Sponsoring organization: Flex Monitoring Team
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Toolkit designed to help State Flex Programs (SFPs) with manage and document project performance and comply with the Federal Office of Rural Health Policy's expectations regarding outcome measurement and reporting. Provides blank worksheets for SFPs as they work through the steps for their projects, as well as links to outcome measurement resources.
Author(s): John Gale, Bridget Harr
Date: 12/2025
Sponsoring organization: Flex Monitoring Team
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MBQIP Fundamentals Guide for State Flex Programs: A Guide for Flex Coordinators on the Current Status of the MBQIP
Provides an overview of the history and current status of the Medicare Beneficiary Quality Improvement Project (MBQIP). Offers links to resources to support Flex program personnel and relevant subcontractors understand the basics of MBQIP.
Date: 11/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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Provides an overview of the history and current status of the Medicare Beneficiary Quality Improvement Project (MBQIP). Offers links to resources to support Flex program personnel and relevant subcontractors understand the basics of MBQIP.
Date: 11/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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RHCs and CAHs Participating in the Medicare Shared Savings Program (MSSP): Characteristics of the Providers and Communities
Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and freestanding versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and freestanding versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Facilitators of Strong Quality and Financial Outcomes in Critical Access Hospitals
Examines leadership traits, management strategies, and other governance and collaboration-based supports for positive quality and financial outcomes in Critical Access Hospitals (CAHs), utilizing insights from interviews of leaders at 10 CAHs which met high financial and quality benchmarks. Provides interview excerpts and identifies themes.
Author(s): Robert Barclay, Zoe Pringle, Megan Lahr, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Examines leadership traits, management strategies, and other governance and collaboration-based supports for positive quality and financial outcomes in Critical Access Hospitals (CAHs), utilizing insights from interviews of leaders at 10 CAHs which met high financial and quality benchmarks. Provides interview excerpts and identifies themes.
Author(s): Robert Barclay, Zoe Pringle, Megan Lahr, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Characteristics of Critical Access Hospitals with High Financial and Quality Metric Performance
Examines Critical Access Hospital (CAH) financial and quality performance utilizing Medicare Beneficiary Quality Improvement Project (MBQIP) data. Provides characteristics of CAHs and their respective measures according to 5 financial and 5 quality benchmarks.
Author(s): Lauren Wallace, George H Pink, Kristie Thompson, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Examines Critical Access Hospital (CAH) financial and quality performance utilizing Medicare Beneficiary Quality Improvement Project (MBQIP) data. Provides characteristics of CAHs and their respective measures according to 5 financial and 5 quality benchmarks.
Author(s): Lauren Wallace, George H Pink, Kristie Thompson, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Medicare Payment Basics: Critical Access Hospitals Payment System
Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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The Evolving Role of Critical Access Hospitals in Rural Physician Training
Research letter examining prevalence of Critical Access Hospital (CAH)-based training and comparing CAHs with other rural teaching hospitals to evaluate potential for expansion. Features statistics on characteristics of training programs in CAHs and other rural teaching hospitals.
Author(s): Lori Rodefeld, Mukesh Adhikari, Catherine (Kasia) Horger, John Boll, Emily M. Hawes
Citation: JAMA Health Forum, 6(10), e254742
Date: 10/2025
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Research letter examining prevalence of Critical Access Hospital (CAH)-based training and comparing CAHs with other rural teaching hospitals to evaluate potential for expansion. Features statistics on characteristics of training programs in CAHs and other rural teaching hospitals.
Author(s): Lori Rodefeld, Mukesh Adhikari, Catherine (Kasia) Horger, John Boll, Emily M. Hawes
Citation: JAMA Health Forum, 6(10), e254742
Date: 10/2025
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